title: Intrinsic motivation: how can it play a pivotal role in changing clinician behaviour?
abstract: OBJECTIVE
  In the light of an increasing healthcare burden, this paper seeks to offer insight about how intrinsic motivation could play a pivotal role in improving the pre-existing healthcare service delivery systems by altering clinician behaviour. The paper argues the case for four salient dimensions worth exploring through the lens of intrinsic motivation--non-financial incentives, positive affective states, organizational culture and prescribing quality.
  
  
  METHODS
  This article reviews literature from both social sciences and health management practices to provide rationale on how intrinsic motivational approaches could optimize healthcare service delivery systems.
  
  
  RESULTS
  The scrutiny of the body of evidence leads to the assertion that there is neglect in the initiatives to reinforce intrinsic motivation as a method to address the ailing morale of doctors. This seems to have exacerbated negative outcomes that include job dissatisfaction, compromise in the quality of care and poor patient-doctor relationships. Diminution in positive affective states amongst doctors, largely controlled by intrinsic motivation, led to strained doctor-patient communication and poor quality of care. Barriers in a healthcare organizational culture that restricts autonomy and empowerment seem to directly undermine job satisfaction.
  
  
  CONCLUSIONS
  The article argues that it is crucial to shift away from the conventional tendencies promoting tangible rewards. A more holistic approach should be adopted by conducting formal research into intrinsic motivation and how it could aid the formulation of policies tailored to meet the current demands of the healthcare system.
authors.affiliation: Primary Healthcare Outpatient Department, Seremban Primary Care Health Clinic, Seremban, Malaysia. yogarabin@gmail.com
authors.forename: Yogarabindranath Swarna
authors.initials: YS
authors.lastname: Nantha
mesh_terms: D002983:Clinical Competence; D003142:Communication; D006801:Humans; D009042:Motivation; D015279:Organizational Culture; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D017009:Professional Autonomy; D011787:Quality of Health Care / Q000592:standards* / Q000639:trends; D012201:Reward